Median arcuate ligament in orthotopic liver transplantation: relevance to arterial reconstruction
| Autor: | Pierre-Philippe Massault, N. Molinier, Bertrand Dousset, Olivier Scatton, Olivier Soubrane, J. Lubrano, Bruto Randone, Paul Legmann |
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| Rok vydání: | 2008 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty Carcinoma Hepatocellular medicine.medical_treatment Anastomosis Liver transplantation Hepatic Artery Celiac artery medicine.artery parasitic diseases Medicine Humans Aorta Abdominal Retrospective Studies Transplantation Aorta Ligaments business.industry Median arcuate ligament Liver Neoplasms Plastic Surgery Procedures medicine.disease Hepatitis B Thrombosis Hepatitis C Surgery Liver Transplantation Mesenteric Arteries surgical procedures operative medicine.anatomical_structure Ligament business Artery |
| Zdroj: | Transplantation proceedings. 40(10) |
| ISSN: | 0041-1345 |
| Popis: | Median arcuate ligament (MAL) syndrome results from luminal narrowing of the celiac artery by the insertion of the diaphragmatic muscle fibers or by fibrous bands of the celiac nervous plexus. In 10% to 50% of cases it is responsible for significant angiographic celiac trunk compression. In orthotopic liver transplantation (OLT), the presence of celiac compression by MAL is considered to be a risk factor for hepatic arterial thrombosis (HAT); it may lead to graft loss. Various surgical procedures have been proposed to overcome the impact of MAL in OLT, but their impact is still ill defined. The aim of our study was to compare standard hepatic artery reconstruction and graft reconstruction (aortohepatic bypass) in terms of HAT among patients with MAL undergoing OLT. We retrospectively reviewed 168 adult recipients of OLT performed from January 1991 to December 1998. Ten cases (5.6%) of celiac compression by MAL were identified after celiomesenteric arteriography. There was no significant difference in terms of HAT incidence when aortohepatic bypass was performed compared to a standard anastomosis; moreover, this was greater in the graft reconstruction group (25% vs 17%; P = .67). In our opinion, the presence of an arcuate ligament should not contraindicate a routine hepatic artery reconstruction. |
| Databáze: | OpenAIRE |
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